Association of preoperative EpCAM Circulating Tumor Cells and peripheral Treg cell levels with early recurrence of hepatocellular carcinoma following radical hepatic resection

作者：Zhou, Yan; Wang, Beili; Wu, Jiong; Zhang, Chunyan; Zhou, Yiwen; Yang, XinRong; Zhou, Jian; Guo, Wei^*; Fan, Jia^*

来源：BMC Cancer, 2016, 16(1): 506.

DOI：10.1186/s12885-016-2526-4

• Hepatocellular carcinoma
• Tumor recurrence
• Circulating tumor cells
• Epithelial cell adhesion molecule
• Regulatory T cells

Background: This study was carried out to determine the prognostic significance of preoperative peripheral epithelial cell adhesion molecule-positive (EpCAM(+)) circulating tumor cell (CTC) and T regulatory (Treg) cell levels in hepatocellular carcinoma (HCC) patients for the prediction of postoperative recurrence following curative resection. @@@ Methods: A total of 49 patients about to undergo curative resection for HCC were recruited into the study. PCR and FACS were used to detect the preoperative levels of EpCAM (mRNA+) CTCs and CD4(+)CD25(+)Foxp3(+) Treg cells. The prognostic value of EpCAM(mRNA+) CTCs, CD4(+)CD25(+)Foxp3(+) Treg cells, and other clinicopathological factors were analyzed by applying the Kaplan-Meier method and the multivariate Cox proportional hazards model. @@@ Results: The number of EpCAM(mRNA+) CTCs and Treg/CD4(+) cells showed significant correlation as prognostic factors of postoperative HCC recurrence: EpCAM(mRNA+) CTC >= 2.22 (P = 0.001) and Treg/CD4(+) >= 5.07 (P = 0.045), with EpCAM(mRNA+) CTC >= 2.22 (P = 0.003, HR = 6.668) being the most important indicator. Patients with high CTC/Treg levels showed a significantly higher risk of developing postoperative HCC recurrence than those with low CTC/Treg levels (66.7 % vs. 10.3 %, P < 0.001). The high CTC/low Treg group also presented higher 1-year recurrence rates compared with the low CTC/low Treg level group (50.0 % vs. 10.3 %, P = 0.004). @@@ Conclusions: Elevated EpCAM(mRNA+) CTC and Treg/CD4(+) levels were associated with early recurrence of HCC, indicative of poor clinical outcome. The combined detection of EpCAM(mRNA+) CTC and Treg/CD4(+) may therefore provide a novel prognostic predictor for HCC patients.

• 出版日期2016-7-20
• 单位复旦大学